A conversation between Kristine Highlander, AAPPN President-Elect, and Graham Patrick, recipient of the AAPPN 2020 Nursing Excellence Award
Graham Patrick is a pioneer ARNP who played a pivotal role in developing academic curriculum so PMHNPs could become educated. During his time at Seattle University, he encouraged the welcoming of non-nurses to the profession through accelerated immersion programs, currently known at SU as APNI. After shifting his role to spend more time in clinical practice, he remained an important advocate for PMHNP education by regularly mentoring students through preceptorship.
I had the distinct privilege of catching up with him by phone from his home in Port Orchard, where he is cultivating the land into a nature sanctuary.
You’ve been in mental health for 50 years and in nursing for over 35 years. What changes stand out to you over your career?
We still deal with some of these demeaning attitudes, and ARNPs around the country are still struggling to get autonomy, but both things have improved considerably.
I was initially in practice as a psychotherapist. My mentor suggested I look into nursing. The formal ARNP role did not yet exist. I was hired as an MD as a research associate for a study investigating ADHD medications. He was demeaning toward nurses but seemed resigned to the fact that he needed us if the work was going to get done. I conducted initial exams, collected histories, and many other things that were ultimately training for my advanced practice work.
Are there any challenges you foresee as having the potential to define us in the coming years?
Health doesn’t always mean medicine.
We need to not lose sight of the patient, amidst all the growing technology. It’s important to find ways to stay focused on providing as much patient care in your day as possible. There can be a lot of pressure from other parts of the care system to that can pull you away from this, but ultimately the ability of Nurse Practitioners to see the whole patient is what makes this role stand apart in the field of medicine.
You have training and experience working in biofeedback. What motivated that, and do you think it’s important for PMHNPs to get training in areas outside the traditional Western paradigms of care?
Anything people do to continue to grow their knowledge about complimentary/alternative medicine would benefit people in the long run.
Some of it was luck, with me being surrounded by leaders in the field of biofeedback. But I have always been interested in finding ways to help patients that can lead to lifelong growth and change. These adjunctive therapies can be difficult to get reimbursed for, but there is research supporting their efficacy. And they can be powerful tools for helping people overcome their psychiatric disorders in a sustained way.
What role has AAPPN played in your career?
I feel a real need for people to join organizations. There’s strength in numbers.
Nurses in Washington State are pioneers in Advanced Practice Nursing. People worked hard to come together to make this happen.
What are you most proud of in your career?
I am so honored to have been able to effect positive change for some young people who were dealing with significant psychiatric issues.
Developing the PMHNP program at SU and getting to do hands-on clinical work with students has been the highlight of my career. There was concern at Seattle University during the development of the APNI program that it would lead to ARNPs with only a superficial view of nursing.
I believed that our system was broken because of people within, and we needed to welcome people from more diverse backgrounds if we were going to improve and evolve the profession. It was challenging—I was a member of a committee at ANCC when they started to develop the PMHNP pathway so I had an understanding of what standards needed to be met, but I needed help to develop the actual curriculum. Pam Dietrich was a big help, especially on developing the Addictions curriculum. We had some hurdles, but ultimately were able to get the PMHNP track started at SU.
It is amazing to be part of their growth and see them achieve things that seemed impossible when I first assumed their care.
What advice would you give to new graduates?
Stay curious. Try new things.
If you don’t like something in your workplace, figure out who the decision makers are and try to find a place to have your say.
Base your practice on evidence, but don’t be afraid to get a little uncomfortable by learning something new. Don’t trust drug studies blindly.
It is also important to be open to other professions—to understand their backgrounds and learn about their training. I volunteered for NCSBN to develop the first national, computer-based NCLEX. It was so worthwhile to be exposed to nurses from a variety of other geographic areas and specialties.